ANTI-DIABETIC AGENTS Flashcards
Transports and metabolizes glucose for
energy
INSULIN
Stimulates storage of glucose in the liver
and muscles (glycogen)
INSULIN
Signals the liver to stop the release of
glucose
INSULIN
Enhances storage of dietary fat in adipose tissue
INSULIN
Accelerates transports of amino acids
into cells
INSULIN
Mechanism of Action
- primarily acts in the liver, muscle and adipose by attaching to the receptors on cellular membranes facilitating the
passage of glucose, potassium and
magnesium
INSULIN (ANTI-DIABETIC DRUGS)
DERIVED FROM: Animal / human - pork ( one different amino acid) - beef ( four different amino acids)
INSULIN
ROUTE: subQ, IV, IM
INSULIN
SIDE EFFECTS & ADVERSE EFFECTS
SOMOGYI EFFECT - hypoglycemic conditions (2-4AM) ► Leads to Stimulate the release of hormones (cortisol, glucagons, and epinephrine) to increase blood glucose lipolysis, gluconeogenesis, glycogenolysis
HYPOGLYCEMIC OR INSULIN SHOCK
Dawn phenomenon – requires increase
insulin dose in early morning hours due to
increased plasma glucose concentration
because of increased cortisol and growth
hormone secretion
HYPOGLYCEMIC OR INSULIN SHOCK
Manifestations of Dawn Phenomenon: H/A,
lightheadedness, nervousness, tremors, excess perspiration, cold clammy skin, tachycardia, slurred speech, memory lapses, confusion, seizure, blood glucose <60 mg/d
HYPOGLYCEMIC OR INSULIN SHOCK
- Inadequate amount of insulin
- Sugar cannot be metabolized, uses fatty
acids for energy
KETOACIDOSIS (HYPERGLYCEMIC REACTION)
Manifestations: extreme thirst, fruity
breath,kussmaul breathing, rapid pulse, dry
mucous membrane, poor skin turgor, blood
glucose > 250 mg/dL
KETOACIDOSIS (HYPERGLYCEMIC REACTION)
Storing Insulin:
► Avoid exposure to extreme
temperature(should not be frozen or kept
indirect sunlight or a hot car)
► Before injection should be at room
temperature (less irritating to tissue)
► Unopened vials are refrigerated until
needed
► Once insulin has been opened: - At room
temperature for one month- In the refrigerator
for 3 months( lose their strength if otherwise)
► Pre- filled syringes should be stored in a
refrigerator and should be used within 1-2
weeks
AMBOT
insulin is delivered from the device through plastic tube with a metal or plastic needle placed sub-q
INSULIN PUMP
- Needle less
- delivered directly through the skin in the fatty tissue
- delivered under high pressure(stinging,pain,
burning and bruising may occur)
INSULIN JET INJECTORS
T OR F: Insulin injected in the abdomen may be absorbed more rapidly than the other sites
TRUE
Main area of injection:
abdomen, arms (posterior surface). thigh
(anterior surface) and hips
INSULIN INJECTION SITES
depression under the skin surface; animal insulin
LIPOATROPHY
a raised lump of knot on the skin surface
LIPOHYPERTROPHY
T OR F: Systemic rotation within one anatomical
area is recommended to prevent lipodystrophy
TRUE
T OR F: Do not use the same site more than
once in a 2 – 3 week period
TRUE
T OR F: Injections should be 1.5 inches apart within the anatomical area
TRUE
T OR F: Heat, massage and exercise of the
injected area can increase absorption
rates = hypoglycaemia Injection into the
scar tissue may delay absorption
TRUE
AKA: Oral hypoglycemic drugs Indication: DM type 2
ORAL ANTIDIABETIC DRUGS
stimulate pancreatic beta cells to secrete more insulin; increase the insulin receptors; increasing the ability of the cells to bind insulin for glucose metabolism
SULFONYLUREAS
short- acting: tolbutamide(Orinase)
FIRST GENERATION SULFONYLUREAS
intermediate acting: acetohexamide( Dymelor), tolazamide (Tolinase)
FIRST GENERATION SULFONYLUREAS
long- acting: chlorpropamide(Diabinese)
FIRST GENERATION SULFONYLUREAS
glimepiride (Amaryl); glipizide(Glucotrol)
2ND GENERATION SULFONYLUREAS
decrease hepatic production of glucose from stored glycogen
BIGUANIDES (NON SULFONYLUREAS)
- Glucosidase Inhibitor
–inhibit digestive enzyme in the small
intestine responsible for the release of
glucose from complex CHina diet
ALPHA (NON SULFONYLUREAS)
stimulate beta cells to release insulin
MEGLITINIDES (NON SULFONYLUREAS)
increase level of incretin hormones, increase insulin secretion, decreased glucagon secretion.
MODIFIER
Metformin
BIGUANIDES (NON SULFONYLUREAS)
acarbose; miglitol
ALPHA (NON SULFONYLUREAS)
repaglinide ; nateglinide D. Incretin
MEGLITINIDES (NON SULFONYLUREAS)
